Nutritional Status of Patients with Hansen's Disease (Leprosy): a Case-Control Study in an Endemic Setting

Hansen's disease (HD, leprosy) is a major public health concern in Brazil. Its microbial aetiology means that nutritional status may be a significant factor in susceptibility and immune response.

Case-control study (n=59 cases, n=59 controls) conducted in Espírito Santo, Brazil from February to December 2025, assessing dietary intake, anthropometry, and biochemical markers of nutritional status.

Cases were characterized by the multibacillary form of HD (n=56, 94.9%), mostly the borderline type (81.4%, n=48). Physical inactivity was more common among cases (81.4%) than among controls (42.4%) (p<0.001), but a higher porportion of cases reporting having a structured diet (86.4% vs. 45.8%, p<0.001). There was no difference in BMI (median 26.3 kg/m²vs. 27.2 kg/m², p=0.638), but cases exhibited lower skeletal muscle mass (median 25.7 kg vs. 31.4 kg, p=0.005) and smaller peripheral circumferences (hip 103.5 cm vs. 112.0 cm, p<0.001; chest 98.0 cm vs. 101.5 cm, p=0.021; thigh 49.0 cm vs. 53.3 cm, p<0.001), consistent with reduced skeletal muscle mass and smaller peripheral anthropometric measurements despite similar BMI, accompanied by higher leptin levels in cases (18.0 vs. 11.0 ng/mL, p<0.001). Cases had lower median levels (p<0.001) of haemoglobin (11.8 vs. 13.5 g/dL); vitamin B₁₂ (235 vs. 420 pg/mL), vitamin D (21.4 vs. 39.7 ng/mL), zinc (60.6 vs. 88.2 mcg/dL), and selenium (62.4 vs. 89.0 mcg/L).

HD is associated with multidimensional vulnerability, reflected in marked differences in micronutrient and biomarker levels that warrant further investigation, and that indicate a need to integrate routine nutritional screening into HD patient care.